Feeling short of breath during activities that used to be easy should never be brushed off as simply 'getting older' or 'being unfit'. In fact, breathlessness can be a critical warning sign of heart disease that is often overlooked until the condition progresses. Seeking a cardiology consultation or breathlessness specialist for a timely heart disease assessment can provide you with either reassurance or crucial early treatment, when outcomes are most favorable.
Breathlessness can stem from heart issues, lung conditions, or general health factors. Common causes include:
Heart-related (cardiac) causes:
- Heart valve disease — particularly aortic stenosis, which refers to a narrowing of the heart's main outflow valve. Breathlessness on exertion is often its first and most significant symptom.
- Heart failure — when the heart cannot pump efficiently, fluid can accumulate in the lungs, leading to breathlessness on exertion, when lying flat, or even waking you at night.
- Coronary artery disease — narrowed heart arteries can cause breathlessness rather than chest pain; this is sometimes referred to as an 'angina equivalent.'
- Heart rhythm issues — such as atrial fibrillation, which can decrease the heart's efficiency.
- Cardiomyopathy — diseases affecting the heart muscle itself.
Non-cardiac causes:
- Lung conditions such as asthma, COPD, or infections.
- Anaemia (low blood count).
- Being overweight or out of shape.
- Anxiety.
Many of these conditions can coexist, and often, cardiac causes of breathlessness can be overlooked when symptoms are dismissed as a result of age, weight, or fitness. A thorough cardiology consultation and structured heart disease assessment are essential to accurately identify or rule out heart disease.
You should arrange a prompt cardiac assessment with a breathlessness specialist if you notice:
- Breathlessness during activities you previously managed comfortably, such as climbing stairs, walking uphill, or carrying shopping.
- A gradual reduction in how far or fast you can walk.
- Breathlessness when lying flat, or waking at night gasping for breath.
- Breathlessness accompanied by swollen ankles, palpitations, chest tightness, or dizziness.
- Breathlessness that is progressively getting worse over weeks or months.
This is especially important if you are over 65 or have risk factors like high blood pressure, high cholesterol, diabetes, or a heart murmur. In cases such as aortic stenosis, the onset of breathlessness signifies the need for a cardiology consultation, as the condition often requires assessment and treatment. Early detection leads to significantly better outcomes in heart disease management.
Your first appointment with a breathlessness specialist lasts up to 45 minutes and includes:
A detailed discussion of your symptoms — when the breathlessness occurs, how it has changed over time, and what activities you can no longer do that you once could.
A review of your risk factors and medical history, including any known murmurs or previous heart problems, as part of a comprehensive cardiology consultation.
A physical examination — listening to the heart and lungs and checking for signs of fluid retention as part of your heart disease assessment.
A clear plan — I will explain the likely causes and arrange the right investigations quickly.
As a breathlessness specialist, I guide the assessment of breathlessness based on your symptoms and examination findings. I can rapidly arrange several key investigations during your cardiology consultation, including:
- **Echocardiogram** — the primary test for breathlessness, featuring an ultrasound scan that reveals the heart's pumping function and evaluates all four valves.
- **ECG** — to identify rhythm problems and signs of heart strain.
- **Blood tests** — including NT-proBNP, a crucial marker of heart failure, as well as tests for anaemia and thyroid issues.
- **CT coronary angiogram** — a non-invasive scan that examines the heart's arteries.
- **Exercise or stress testing** — to evaluate your heart's performance under exertion and objectively measure any limitations.
- **Ambulatory heart monitoring** — if a rhythm problem is suspected.
- **Invasive coronary angiography** — when coronary artery disease requires definitive assessment, which is performed personally by me.
Most patients complete their initial heart disease assessment and key investigations within one to two weeks.
Treatment depends entirely on the cause:
Heart valve disease — mild disease is monitored; significant disease may need valve intervention. I perform TAVI for aortic stenosis, a minimally invasive keyhole valve replacement carried out through a small puncture in the groin, with most patients home within a day or two.
Coronary artery disease — treated with medication and, where needed, coronary angioplasty and stenting (PCI).
Heart failure — modern medications are highly effective and can transform both symptoms and long-term outlook when started early.
Heart rhythm problems — managed with medication or referral for specialist rhythm procedures.
If you're experiencing symptoms like breathlessness, I can help you as a breathlessness specialist, ensuring you receive the right cardiology consultation. If your heart is healthy, you receive clear reassurance, and I will point you towards the right assessment for any non-cardiac causes.
Because I am an interventional and structural cardiologist, your diagnosis and any procedure you need can be managed as a single, seamless pathway.
As a breathlessness specialist, I am an Interventional and Structural Cardiologist with subspecialty expertise in aortic stenosis, TAVI, and coronary artery disease—key cardiac contributors to breathlessness. I hold a PhD from King's College London and have completed advanced fellowship training in Milan, contributing to over 100 peer-reviewed publications. I offer rapid access with same-week cardiology consultations at Welbeck Street (Marylebone), Cromwell Hospital (Kensington), and The Wellington Hospital (St John's Wood). My approach ensures end-to-end care—from the initial heart disease assessment and consultation through echocardiography to valve intervention or stenting, all under one consultant. Consultations are available in English and Turkish, and I am recognized by all major private medical insurers; self-paying patients are also welcome.
Breathlessness that limits your life deserves expert answers — quickly. For a thorough heart disease assessment, contact my practice team to arrange a cardiology consultation with a breathlessness specialist.
Reach out to Ms. Melinda Ziff (PA) at 020 3198 9826 or drozandemir.sec@outlook.com to schedule your consultation.